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Sickle cell trait (SCT) is associated with an increased prevalence of exertional rhabdomyolysis, chronic renal disease, and venous thromboembolism (NEJM JW Oncol Hematol Jan 2019 and Ann Intern Med 2018; 169:619), leading to recommendations for reproductive counseling and newborn screening. However, there is uncertainty about when to institute such counseling and how screening data might be used to benefit affected individuals and family members.
To address these concerns, investigators reviewed the recent literature and proposed a decision tree that begins with a woman whose SCT screening test is positive. If she is considering pregnancy, hemoglobin electrophoresis is recommended for both partners. Should there be a risk that the baby might…